[from John - Image added by Ira] I am posting my comments as a separate Topic because my view shifts the discussion and it seems more appropriate to post it separately.
I can understand a government run MINIMAL universal health care plan, similar to Medicare, a plan that is evenly applicable to all who have paid their FAIR SHARE of the costs. I can also envision a MINIMAL universal health care plan for those citizens who are TRUELY needy including children for which I should bear my fair share of the burden, (please note my emphases).
With that said, I must return to the main principle I and most of us elderly were raised to follow - responsibility.
I wish to make my own decisions regarding my health care and if I make a mistake, I accept the responsibility as I have done on all matters throughout my life. If I, with or without my doctor’s advice, select a treatment and it is more expensive or less effective than the government’s choice or my doctor’s suggestion then so be it. I made the choice and I will bear the consequences.
I can understand Stu’s and others position. Comparative Effectiveness Research (CER) and Quality Adjusted Life Years (QALY) are necessary to a government run health care system as is the necessity that it be self-sustaining. It will also be necessary to refuse treatments that are proven ineffective. A government run health care system should not over burden society nor should it forward its burdens into the future, nor should it inequitably burden certain elements of society.
Touching on the elderly, QALY, some might say, is a form of euthanasia I disagree. First, a government’s first responsibility to toward its productive citizens, second, it is responsible to ease the effect of aging. I as a responsible citizen must be willing to accept that the government will ease my remaining years but do no more than that.
Finally, I as a responsible citizen, have the responsibility to provide for my welfare in my retirement. Some citizens will be able to provide better for themselves than others will, that is why I agree with a minimal health care system. However, how can I have free choice amongst several treatments for a medical problem while the government’s system properly says it will only pay for the least expensive, effective treatment? My suggestion is, let’s assume that there are four treatments that are effective costing, a-$1300, b-$1000, c-$1500 and d-$1700. The government, rightly, should offer treatment b. However, if I wish to choose treatment c then the government plan should pay $1000 and I should be responsible for the remaining $500. I believe this is an appropriate blend of government and individual responsibility.